2021 TRUST Mentor of the Year Award Submission Form

Nominator Information

Question Title

* 1. Provide us with your contact information. Any person, whether a member of the Women’s Health Leadership TRUST or not, may nominate someone for the Mentor of the Year Award.

Your Name: *

Your Email: *

Your Phone: *

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* 2. Nominee Information

Provide us with the nominee’s information. All nominees must be members of the Women’s Health Leadership TRUST. Professional coaches are not eligible for the Mentor of the Year Award.

Nominee Name: *

Nominee Role: *

Nominee Email: *

Nominee Phone: *

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* 3. Short description of the relationship of the nominating individual(s) and nominee: *

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* 4. Short description of the impact the nominee had on the individual(s), team, group or environment: *

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* 5. Nominee Attributes

Provide short descriptions of how the nominee demonstrates these attributes. Please complete at least three (3) of the following six (6) sections. Be as specific as possible with your examples.

Strong Communicator:
• Actively listens
• Inquisitive to learn about others
• Clear and transparent in thought delivery

Accessible / Approachable:
• Open to all ideas, thoughts and needs
• Flexible to creates access and availability in order to connect
• Welcoming and pleasant

A Connector:
• Demonstrates ability make positive connections
• Willingness to share and open personal network

Integrity / Genuine:
• Recognized for honesty
• Demonstrates genuine interest in the needs of others
• Compassionate for all individuals

Wisdom:
• Advises without judgement
• Provides relevant and useful insight and guidance
• Demonstrates aspirational qualities and achievements

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* 6. Please provide examples of selected attributes:

Strong Communicator Example:

Accessible / Approachable Example:

A Connector Example:

Integrity / Genuine Example:

Wisdom Example:

2021 TRUST Mentor of the Year Award Submission Form

Question Title

* 1. Provide us with your contact information. Any person, whether a member of the Women’s Health Leadership TRUST or not, may nominate someone for the Mentor of the Year Award.

Question Title

* 2. Nominee InformationProvide us with the nominee’s information. All nominees must be members of the Women’s Health Leadership TRUST. Professional coaches are not eligible for the Mentor of the Year Award.

Question Title

* 3. Short description of the relationship of the nominating individual(s) and nominee: *

Question Title

* 4. Short description of the impact the nominee had on the individual(s), team, group or environment: *

Question Title

* 5. Nominee Attributes Provide short descriptions of how the nominee demonstrates these attributes. Please complete at least three (3) of the following six (6) sections. Be as specific as possible with your examples.

Question Title

* 6. Please provide examples of selected attributes:

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* 7. Anything else you think we should know about the nominee?

* 2. Nominee Information

Provide us with the nominee’s information. All nominees must be members of the Women’s Health Leadership TRUST. Professional coaches are not eligible for the Mentor of the Year Award.

* 5. Nominee Attributes

Provide short descriptions of how the nominee demonstrates these attributes. Please complete at least three (3) of the following six (6) sections. Be as specific as possible with your examples.